METHODS: ACLF patients recruited from the APASL-ACLF Research Consortium (AARC) were followed up till 30 days, death or transplantation, whichever earlier. Clinical details, including dynamic grades of HE and laboratory data, including ammonia levels, were serially noted.
RESULTS: Of the 3009 ACLF patients, 1315 (43.7%) had HE at presentation; grades I-II in 981 (74.6%) and grades III-IV in 334 (25.4%) patients. The independent predictors of HE at baseline were higher age, systemic inflammatory response, elevated ammonia levels, serum protein, sepsis and MELD score (p
Material and methods: A randomised prospective study of 102 children (mean age 8.3 ± 3.5 years) with fractures involving upper or lower limbs. Children undergoing removal of cast were divided into 2 groups; either by an oscillating saw or a cast cutting shear. The level of anxiety was assessed by recording the heart rate with a portable fingertip pulse oximeter before, during and after removal of the cast. Objective assessment was performed by documenting the fear level on Children's Fear Scale (CFS).
Results: There was a significant increase in the heart rate of children during cast removal while using the oscillating saw compared to cast shear (p<0.05). The noise level produced by the saw exceeded 80 dB (mean 103.3 dB). The fear level was significantly lower in the cast shear group (p<0.05).
Conclusion: The noise produced by the oscillating saw was associated with an increased anxiety level in children undergoing cast removal. Cast shear is a simple and inexpensive instrument that can be used for cast removal in overly anxious children.
METHODS: Detailed phenotyping and next-generation sequencing (panel and exome).
RESULTS: Our analysis revealed 224 pathogenic/likely pathogenic variants (54 (24%) of which are novel) in 123 genes with established or tentative links to skeletal dysplasia. In addition, we propose 5 genes as candidate disease genes with suggestive biological links (WNT3A, SUCO, RIN1, DIP2C, and PAN2). Phenotypically, we note that our cohort spans 36 established phenotypic categories by the International Skeletal Dysplasia Nosology, as well as 18 novel skeletal dysplasia phenotypes that could not be classified under these categories, e.g., the novel C3orf17-related skeletal dysplasia. We also describe novel phenotypic aspects of well-known disease genes, e.g., PGAP3-related Toriello-Carey syndrome-like phenotype. We note a strong founder effect for many genes in our cohort, which allowed us to calculate a minimum disease burden for the autosomal recessive forms of skeletal dysplasia in our population (7.16E-04), which is much higher than the global average.
CONCLUSION: By expanding the phenotypic, allelic, and locus heterogeneity of skeletal dysplasia in humans, we hope our study will improve the diagnostic rate of patients with these conditions.
Methods: A comparative cross-sectional study design was done among female medical and nursing students during their clinical practice.
Results: Total respondents were 481 female medical and nursing students (response rate of 96.2%). About 17.8% of medical and 18.8% of nursing students had been sexually harassed. The most common harasser for medical and nursing students were males (51.2% and 48.8%, respectively), patients (39.7% and 60.3%, respectively), age 30s (41.0% and 59.0%, respectively) and 40s (65.5% and 34.5%, respectively), occurred in medical wards for both groups (50% each). From the SH checklist, 76.9% of medical and 73.5% of nursing students had experienced at least one item of the total 18 items. The abnormal sexual desire of an individual was chosen as the reason for SH by 44.9% of medical and 33.8% of nursing students. The majority of respondents said the issue of SH in clinical practice was very serious. Around 32% of medical students choose the fear of being disadvantaged during clinical practice as the reason why the victims kept quiet while 41.5% of nursing students chose because of not having evidence. Both groups of students suggested establishing rules and laws relating to SH (30.8% and 35.5%, respectively) as effective methods to prevent it. About 75.3% of medical and 81.6% of nursing students agreed that it was very necessary for implementing a SH prevention program.
Discussion: Although SH is not a new issue, there is insufficient exposure about SH among medical and nursing students. This can be corrected by increasing their knowledge and awareness about SH.